Health

Medical termination of pregnancy

Article Abstract:

Medical abortion using drugs is not as effective as surgical abortion, but it may be the only choice in countries where properly trained surgeons are not available. In the US, many abortion clinics have been targeted by right-to-life groups. Consequently, all women would benefit from drugs that could induce abortion. These drugs include methotrexate, epostane, synthetic prostaglandins such as misoprostol and gemeprost, and mifepristone. Medical abortion has more adverse effects than surgical abortion but it is safe and women don't have to be anesthetized.

Mifepristone (RU 486) is a derivative of progestin that has several different uses. The anti-progesterone activity of mifepristone affects the lining of the uterus and the secretion of certain hormones. When given to pregnant women, it interferes with the supply of progesterone to the lining of the uterus. This causes disruption of the placenta and results in termination of the pregnancy. Mifepristone can be used to induce abortion within nine weeks of a woman's last menstrual period. It is also used to prevent pregnancy and to induce labor. Women with breast cancer or endometriosis may benefit from treatment with mifepristone. Mifepristone interferes with the activity of glucocorticoids, so that it also can be used to treat some patients with Cushing's syndrome caused by secretion of ectopic corticotropin or cancer of the adrenal gland.

Early pregnancy termination with mifepristone and misoprostol in the United States

Article Abstract:

Mifepristone and misoprostol combined appear to be effective in terminating pregnancy when given at an early stage. Researchers gave this combination to 2,015 pregnant women. Pregnancy was terminated in 92% of the women pregnant for 49 days or less, 83% of the women pregnant for 50 to 56 days and 77% of the women pregnant for 57 to 63 days. In three-quarters of the women, the pregnancy was terminated within 24 hours. Failure was associated with longer duration of pregnancy as was the incidence of side effects.